Gyroscopes, wi-fi used for better knee surgery

First in Israel: Gyroscopes and wi-fi migrate from aircraft and Internet to Hadassah ORs for better knee replacement surgery.

The iAssist Knee 370.
(photo credit:Courtesy Hadassah Medical Center)

Gyroscopes that keep aircraft steady and smartphones facing the right way, and
wi-fi for wireless Internet use, are integrated in a new technique introduced in
Jerusalem to replace damaged knee joints.

Prof. Meir Liebergall, chairman
of the department of orthopedic surgery at Hadassah University Medical Center in
Jerusalem, was part of a team that performed four such knee replacement
operations, among only a small handful in the United States, Canada and
Germany.

Liebergall, a leading expert in computer-guided surgery on hips
and other parts of the body, was a member of a very small clinical advisory
group to the American company that developed the technology.

Called
iAssist Knee, the personalized guidance system for knees was developed by the
Zimmer Holdings company, a world leader in developing technologies and tools for
orthopedic surgery, based in Warsaw, Indiana.

The small gyroscope in the
device enables surgeons to accurately situate the bone at the proper plane and
provides them with the precise angle for the incision. The wi-fi component makes
possible communication between the tool on the patient’s knee bone and the
operating room computer.

Together, the gyroscope and the wi-fi give
surgeons maximum accuracy, resulting in less blood loss for the patient, faster
recovery and the use of much less equipment. Under the old system, dozens of
devices are used to perform such surgery.

Leibergall performed the
surgery at the Mount Scopus Hadassah University Medical Center with Dr. Yoav
Mattan (director of Hadassah’s joint replacement unit) and their colleagues Dr.
Gurion Rivkin and Dr. Leonid Kandel.

Weak-kneed patients needing such
surgery are typically over the age of 60 and/or obese.

The unit performs
more joint replacements of all kinds than any other Israeli hospital, with 700
such operations already carried out, 250 of them knee replacements using the
previous technology. The International Society for Computer- Assisted Orthopedic
Surgery has designated Hadassah’s department as a Center of Excellence for its
accomplishments and its innovative use of new technologies and surgical
tools.

In 2004, Liebergall and Mattan performed the world’s first
computer-assisted hip replacement, then too using Zimmer
technology.

“iAssist is yet another step forward in the advancement of
computer-assisted orthopedic surgery,” said Liebergall.

“We are proud
that Hadassah continues to play such a pivotal role and that internationally
recognized leaders in the field such as Zimmer launch their flagship products at
Hadassah. It makes the surgeon’s work more accurate and with a better outcome,”
said Liebergall.

“Two years were spent developing the prototype,”
Liebergall told The Jerusalem Post. “The new technology does not require a
straight line of site between the components.”

He doesn’t know what the
eventual price of such surgery would be, or when it would be included in the
basket of health services.

“But it will save a lot. At present, Zimmer’s
cost includes the costs of development, but it will go down.”

The
Hadassah orthopedic surgeon added that some of his colleagues are reluctant to
use computer-guided equipment because they don’t feel very comfortable when
their hands are not touching the patient. This advance could break down this
reluctance among them, he said.

No medical journal articles have been
published proving efficacy and improvement compared to previous techniques,
Liebergall said, “because it is so new. But I believe it is definitely the
future or joint replacement surgery.”

Despite the lack of organized
scientific research, the US Food and Drug Administration has awarded clearance
to Zimmer Holdings to market iAssist Knee.